안구내용적출 시 자가통증조절장치를 이용한 선제적 전신 진통제의 효과
Effect of Preemptive Systemic Patient-controlled Analgesia in Evisceration
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목적: 안구내용적출 시 자가통증조절장치(patient-controlled analgesia, PCA)를 이용한 선제적 전신 진통제 투여가 수술 후 통증에미치는 영향을 알아보고자 하였다. 대상과 방법: 본원에서 전신마취하 안구내용적출을 시행한 환자 중 수치평가척도(numeral rating scale, NRS)를 통한 통증 평가가가능하였던 55명을 수술 후 PCA를 투여한 그룹(group 1)과 수술 전 선제적으로 PCA를 투여한 그룹(group 2)으로 나누었다. 두 군의수술 당일과 수술 후 1, 2, 3일째의 통증 정도를 NRS로 비교하였으며, PCA 외 추가적인 진통제 사용 여부를 비교하였다. 결과: 총 55명의 환자 중 group 1은 17명, group 2는 38명이었다. 수술 당일 3시간, 5시간, 7시간 후의 NRS는 group 2에서 낮은경향을 보였으나 유의미하지 않았다. 수술 후 1, 2일째의 NRS는 group 2에서 유의미하게 낮게 나타났으며(p=0.014, 0.027), 수술후 3일째의 NRS도 유의미하지 않지만 낮았다(p=0.059). 수술 후 추가적인 진통제가 필요하였던 경우 또한 수술 후 0, 1, 2, 3일째모두 group 1에 비해 group 2에서 유의미하게 적었다(p=0.001, <0.001, <0.001, 0.008). 결론: 안구내용적출 시 PCA를 이용해 선제적으로 전신 진통제를 투여한 경우 수술 후 통증 정도가 유의미하게 감소하였으며, 추가진통제 없이 PCA 자체만으로도 통증이 조절된 비율이 높아 효과적인 투여 방법이었기에 이를 보고하고자 한다.
Abstract
Purpose: To investigate the effect of preemptive systemic analgesia using patient-controlled analgesia (PCA) on postoperative pain after evisceration. Methods: Of the patients who underwent evisceration under general anesthesia in our hospital, 55 who were able to evaluate pain using a numeral rating scale (NRS) were included. The patients were divided into two groups: group 1 used PCA after surgery, and group 2 used PCA preemptively before surgery. We compared the two groups in terms of the NRS pain scores on the day of surgery and 1, 2, and 3 days after surgery, and according to whether additional analgesics were used. Results: The 55 patients included 17 in group 1 and 38 in group 2. The NRS at 3, 5, and 7 hours on the day of surgery tended to be lower in group 2, but not significantly (p > 0.05). The NRS on days 1 and 2 after surgery was significantly lower in group 2 (p = 0.014 and p = 0.027, respectively), and the NRS on day 3 after surgery was also lower, although not significantly (p = 0.059). Significantly fewer cases required additional analgesics in group 2 compared to group 1 on the day of surgery and 1, 2, and 3 days after surgery (p = 0.001, p < 0.001, p < 0.001, and p = 0.008, respectively). Conclusions: Using preemptive systemic PCA in evisceration significantly reduced the postoperative pain, and PCA itself was an effective administration method due to the high rate of pain control without the need for additional analgesics.
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